Chapter 2: For your own good

Wow.. this chapter is saturated in heavy trauma and complex brain physiology that was difficult to process each in its own way, but both abstract and fairly new in their relevant fields. We follow the shocking story of Sandy who witnessed and experienced atrocities at an extremely undeveloped age.

When Perry described the details of those unspeakable acts my immediate response was, ‘Oh, how resilient she must be.’ However, assuming that her resiliency is a presumable response to her trauma; it is in some way doing her a huge disservice. Why? When I make an assumption that she is automatically resilient I negate or overlook the underlying consequences of the trauma. If I assume that just because she is a child, that she can easily bounce back, then I don't take into consideration the real bio-physical responses of her trauma are usually misinterpreted and/or labeled as ADHD or ODD. I would fail to consider that this child is walking, breathing, and eating, yet could be living and reliving memories of pain and agony that I can't even begin to understand. Although I may not see that this child is suffering, we can't automatically assume that she (or other kids who have experienced trauma) are resilient based on the simple fact that they are kids. What we observe as visible functioning does not paint the whole picture. In many ways it is like the definition of health as defined by the World Health Organization, “a state of complete physical, mental and social well-being and not merely the absence of illness” (as cited in Allen, 2016, p. 70). Resiliency is not just necessarily the absence of devastating observable behaviors, but rather a state of equanimity between the different facets of their well-being. With this definition, would you or I be comfortable calling a student resilient without really understanding the depths of their mind?

We as practitioners may have capitalized on this word because we just assume that kids will be okay, as mentioned by a criminal investigator on page 38, "Children are resilient. They will be fine" (Perry & Szalavitz, 2006). In using this word, we are creating expectations for children that they will be okay. What if they aren't? And if they aren't, what shall we do? It is undeniable that youth are strong, capable, flexible, creative, humorous, adventurous, yet they are not adults and they do not possess adult brains. Therefore, the authors do a great job at helping us understand the science of the brain to breakdown how the malleable and susceptible brain of a youth is not meant to withstand these trauma experiences and when they do, labeling them as resilient does nothing to support their young brains; empowering them does. 

Giving youth power is giving them control, just as Dr. Perry described in his sessions with Sandy. Upon hearing of this, I kept getting lost in my thoughts and experiences with one particular student client. Without sharing very many details, he would go into these dissociative states and had frequent interpersonal conflicts with students and teachers. When he came to see me at school, I knew that I had to give him control in our sessions together. I would often hear his teachers and administration call him manipulative, which is a word that I causes me to feel some type of way, because I knew that he was acting (or reacting) that way to meet a need. “After all, one of the defining elements of a traumatic experience- particularly one that is so traumatic that one dissociates because there is no other way to escape from it –is a complete loss of control and a sense of utter powerlessness. As a result regaining control an important aspect of coping with traumatic stress” (Perry & Szalavitz, 2006, p. 52). The authors explanation put many things in perspective about student’s behavior and was a huge sense of relief because it essentially validated all of the work I was already doing. Using this direct quote will give me direct evidence that I can share with school staff about why I do what I do and why students do what they do and why they need control.

Chapter One: Tina's World

In Perry's first chapter he introduces us to his first adolescent patient, Tina.  In this chapter, Perry recounts his initial encounters with trauma exposure at those formative ages and their effect on the bio-physio-emotional development of a person. We are invited along Perry's inquisitive journey through his neuroscience framework to get a better understanding of how Tina's sexual abuse and stressful living environment has impacted her nascent brain. Perry starts to connect what he knows about the biology of the brain into explaining the missing pieces of the puzzle to help explain the link between these adverse events and their effects on a child.

            What made me do this  🙌🏽was the when Dr. Bruce Perry refused to accept the supervisory consultation of this first supervisor, Dr. Robert Stine. It would have been very simple for Perry to simply place an obsolete diagnosis on Tina and prescribe her medication and move one. However, for Perry, doing so would have ignored the blatant environmental factors/stressors that we know as social workers are crucial to a client’s assessment. It was encouraging to read that Perry, a doctor/psychiatrist, was more interested in understanding Tina as a person and all of her history than simply putting a label on her and 'treating' her with medication, which we know at times in the medical world can be used a band-aid for treating underlying issues. 😩

Another 🙌🏽 moment came when under the poor supervisory feedback of Dr. Stine, who interpreted Sara’s tardiness to Dr. Perry’s sessions as “resistance” (Perry, 2006, p. 14). Again, Dr. Perry could have taken the misguided feedback as certainty, yet Perry, who in those moments (with Dr. Stine) thought more like a clinical social worker, was really trying to understand the barriers that Sara faced in explaining her being late to sessions....and he acted more like a LCSW (in doing the ‘home visit’) to realistically understand this families circumstances which gave the client the benefit of the doubt. 

The word 'resistance' really creates resistance in me 😤. This word is too often used with adolescents and more specifically African-American and Latinx youth that don't conform to an adult society and a majority European American culture. Using this word does not invite anything but blame, shame, and judgment towards clients whose lives are complicated by the many "isms" that are woven into our society and institutions. If Dr. Perry, had continued this treatment with this mentality then he would have never had the chance to see for himself the sacrifices that Sara was taking for her family. He saw firsthand her courage, adeptness, and tenacity to take care of her family which would have been misinterpreted for a false assumption that she was envious of Dr. Perry and didn't want Tina to improve 😡. 

I hear this narrative all the time in the school setting (where I am employed) in the relationship with teachers and students. Many of them are not aware of the complicated and detrimental experiences that the students sitting in their chairs have faced or are facing day in and day out. A lot of what I hear is, 'I understand that they have been through rough things, but that doesn't excuse their behavior in class.' I bet their relationship and their approach to working with those students would be a lot different if they were to actually sit down with students and/or do home visits to get a better understanding of their story.